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病例报告:掩盖过早的心室收缩和产品内部相互作用导致心室节律失常

Aravinthan Vignarajah¹, Jose Aguilera², Justin Z Lee²

¹Department of Internal Medicine, Cleveland Clinic Fairview Hospital, Cleveland, OH, USA.

Journal of electrocardiology

|June 18, 2025

概括

植入式心脏转换器-除器 (ICD) 很少会导致心律失常. 在一个心脏沙丘症患者中,特定的时间相互作用掩盖了早发性心室收缩,触发了心室动脉冲动和动. 重编程ICD解决了这个问题.

科学领域:

心脏病学心脏病学
电力生理学电力生理学
医疗器械医疗器械

背景情况:

植入式心脏转换器-除器 (ICD) 对于管理危及生命的心室节律失常至关重要.
很少情况下,ICD可以矛盾地导致心律失常,因为设备与患者的相互作用.
心脏类炎症是一种炎症状况,可以影响心脏的电气系统.

研究的目的:

报告一种罕见的ICD诱导的多形心室性心动减速和心室的病例.
阐明导致心律失常的特定设备内定时机制.
强调量身定制的ICD编程在预防设备相关并发症方面的重要性.

主要方法:

一个44岁的男性患有心脏型发育症的病例报告.
分析过早心室收缩 (PVCs) 与ICD的心室空白期之间的相互作用.
将设备从DDD重新编程到VVI模式作为干预.

主要成果:

患者经历了复发的多形心室性心动减速 (VT) 和心室动 (VF).
PVC被ICD的心房后节奏心室空白期掩盖了.
这种"R-on-T"现象,在脆弱时期由心室节奏触发,诱导了VT/VF.
重编程到VVI模式成功消除了设备诱导的心律失常.

结论:

个性化ICD编程对于预防设备诱导的心律失常至关重要.
了解设备内部时间相互作用对于管理患有复杂心脏病的患者至关重要.
这一案例强调了需要仔细评估易发生心律失常的患者的ICD行为.

关键词:

节律失常 (arrhythmia) 是一种心律失常.设备编程设备编程可植入的心脏转换器除器过早的心室收缩是什么意思 R 在 T 节奏上.

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